Coeliac disease in children
The classic symptoms of coeliac disease in children include:
- failure to thrive
- muscle wasting
- poor appetite
- abdominal distension
- change of mood and emotional distress.
If your child is suffering from any of the symptoms listed, they could have coeliac disease. The first step in diagnosis is to discuss your concerns with your child's GP. Do not remove gluten from their diet until they are diagnosed by a healthcare professional.
Guidelines published by the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) and Coeliac UK recommend that children who have symptoms of coeliac disease and a blood test that shows high levels of antibodies may not need to have a biopsy to be diagnosed with the disease. Instead, a second antibody blood test followed by a genetic test can be used to confirm the diagnosis. Your child’s GP can refer them to a paediatric gastroenterologist to make sure the correct tests are carried out.
These guidelines reflect the improved accuracy and reliability of the antibody blood tests. The waiting time for a biopsy may be several weeks and can be a factor in delaying diagnosis and starting treatment with the gluten free diet. If there is no need for biopsy, the diagnosis process is much quicker, which is good news for the child.
Follow up for children
The BSPGHAN recommend ongoing monitoring by an experienced paediatric dietitian and paediatric gastroenterologist. Children should be followed up six to 12 months after diagnosis followed by a yearly check up after this. This should include an antibody blood test every year or less often. Another biopsy may be offered but is not carried out routinely.
Children should also have their height and weight checked to monitor their growth and development.
However, if you or your child’s symptoms have not improved or have got worse since following the gluten free diet, speak to your healthcare team.
Managing your child's coeliac disease and ensuring they receive the appropriate follow up care can be overwhelming. Check out our interviews with top coeliac disease experts below for tips on what care to expect.